Bone oedema predicts erosive progression on wrist MRI in early RA--a 2-yr observational MRI and NC scintigraphy study

Palosaari, Kari; Vuotila, Jorma; Takalo, Reijo; Jartti, Airi; Niemelä, Raija K.; Karjalainen, Anna; Haapea, Marianne; Soini, Irma; Tervonen, Osmo; Hakala, M

doi:10.1093/rheumatology/kel137

Cited by 94 publications

(51 citation statements)

References 31 publications

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“…the strongest independent predictor of radiological progression [15]. Palosaari et al found a close relationship between bone-marrow edema and subsequent articular erosions in their 2-year study [16]. Ostgendorf et al studied the diagnostic efficacy of duplex ultrasound, positron emission tomography (PET), and mini-arthroscopy and found this combination useful for the early detection of pathomorphological abnormalities, as well as for the prediction of prognosis [17].…”

Section: Discussionmentioning

confidence: 99%

Anti-granulocyte scintigraphy in early rheumatoid arthritis — does it work?

Horkay

Kincse²,

Varga

et al. 2013

Open Medicine

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Section: Discussionmentioning

confidence: 99%

Anti-granulocyte scintigraphy in early rheumatoid arthritis — does it work?

Horkay

Kincse²,

Varga

et al. 2013

Open Medicine

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“…Mori et al [12] proposed the use of MIP images reconstructed from transverse, T1-weighted, contrast-enhanced MR images after fat saturation and suggested the introduction of a new scoring system for MIP imaging of the hand in rheumatoid arthritis. Usually, reproducible scoring systems such as the Outcome Measures in RA Clinical Trials (OMERACT) include the assessment of bone erosions, bone marrow oedema and synovitis volume [13], which are considered the key factors for predicting erosive progression [14]. According to the rheumatoid arthritis magnetic resonance imaging system (RAMRIS) criteria, bone erosions have to be detectable in two, preferably axial and coronal, image planes, whereas bone marrow oedema is best depicted upon non-contrast-enhanced, T2-weighted All analyses were performed including all joints and tendon sheaths images after fat saturation, preferably in the coronal plane [15].…”

Section: Discussionmentioning

confidence: 99%

Synovitis maps for the assessment of inflammatory diseases of the hand

et al. 2011

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Objectives To compare accuracy and review times of FLASH-MRI-derived synovitis maps (SM) with conventional MR images (cMRI) in the assessment of articular synovitis and tenosynovitis of the hand. Methods 80 hands in 40 patients (mean age, 48 years; range, 15-72 years) were assessed for synovitis on cMRI and SM by two readers independently. Reporting times and diagnostic confidence (scale: 1=least, 5=most confident) were measured. Results from an assessment of a panel of senior musculoskeletal radiologists served as the standard of reference. Results Sensitivity and specificity for the detection of articular synovitis were 0.91/1.00 (R1) and 1.00/0.67 (R2) on cMRI and 0.87/0.75 (R1) and 0.91/0.45 (R2) on SM and for the detection of tenosynovitis 0.95/0.63 (R1) and 0.67/ 0.79 (R2) on cMRI and 0.67/0.89 (R1) and 0.38/1.00 (R2) on SM. Mean review times (cMRI/SM, sec) were 142/37 (R1) and 167/25 (R2). Mean diagnostic confidence (cMRI/SM) was 3.7/3.4 (R1) and 3.2/3.5 (R2) for articular synovitis and 4.0/4.0 (R1), 3.3/3.7 (R2) for tenosynovitis. Conclusion Synovitis maps provide a comparable diagnostic accuracy to conventional MR images in the assessment of articular synovitis and tenosynovitis of the hand. Because of short review times, synovitis maps provide a fast overview of locations with synovial enhancement.

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“…Various studies have reported that MRI pathology (synovitis, bone erosions or, most often, BME) of the wrist and MCP joints at disease onset in early RA predicts radiographic erosions [108,[126][127][128][129][130][131][132][133][134]. Some looked at the short-term predictive value of MRI after 1 year [108,126,128,130,131], whereas other studies had 2 [128,132], 3 [134], 5 [133], 6 [127], or 10 years [129] of follow-up.…”

Section: Prognosticationmentioning

confidence: 99%

“…Some looked at the short-term predictive value of MRI after 1 year [108,126,128,130,131], whereas other studies had 2 [128,132], 3 [134], 5 [133], 6 [127], or 10 years [129] of follow-up. All studies found MRI to be a highly significant predictor of radiographic erosions.…”

Section: Prognosticationmentioning

confidence: 99%

The impact of MRI on the clinical management of inflammatory arthritides

et al. 2011

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In the past two decades, MRI has gained a major role in research and clinical management of patients with inflammatory arthritides, particularly in spondyloarthritis (SpA), rheumatoid arthritis (RA), and osteoarthritis (OA). MRI is regarded as the most sensitive imaging modality for detecting early SpA in young patients with inflammatory back pain and normal radiographs of the sacroiliac joints. The recently published Assessment of SpondyloArthritis International Society classification criteria for axial SpA include for the first time a positive MRI demonstrating sacroiliitis as an imaging criterion indicative of SpA together with at least one clinical feature of SpA. Recent data show that systematic assessment of sacroiliitis displayed on MRI has much greater diagnostic utility than previously reported and highlight the diagnostic relevance of structural lesions. In RA, MRI has predictive value for the development of disease in new onset undifferentiated arthritis, and MR pathology at disease onset is a highly significant predictor of radiographic erosions. Consequently MRI has been credited with an important role in the new ACR/EULAR 2010 classification criteria for RA. In OA, bone marrow edema (BME) and synovitis may serve as biomarkers in interventional trials. Treatment interventions targeting BME and synovitis observed on MRI in inflammatory arthritides may have a disease-modifying effect as these lesions are potentially reversible and have been shown to be associated with structural progression. Research should focus on the prognostic significance of MRI lesions in larger cohorts and whether adding MRI to routine care improves clinical and radiographic outcome in patients with inflammatory arthritides.

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Bone oedema predicts erosive progression on wrist MRI in early RA--a 2-yr observational MRI and NC scintigraphy study

Cited by 94 publications

References 31 publications

Anti-granulocyte scintigraphy in early rheumatoid arthritis — does it work?

Anti-granulocyte scintigraphy in early rheumatoid arthritis — does it work?

Synovitis maps for the assessment of inflammatory diseases of the hand

The impact of MRI on the clinical management of inflammatory arthritides

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